Atrial septal defect occluder devices and embolization – a case series

Ambarsari, Yuletta Adny and Novenanto, Tandean Tommy and Susantya, Dicky Panditatwa and Supomo, Supomo and Aribowo, Haryo and Kurnia, Yunanto and Amal, Ihsanul and Satriotomo, Irawan (2024) Atrial septal defect occluder devices and embolization – a case series. Bali Medical Journal, 13 (1). pp. 298-304. ISSN 20891180

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Abstract

Introduction: Atrial Septal Defect (ASD) secundum is a commonly occurring congenital heart disease. Patients with unstable hemodynamic may require closure, which can be accomplished either percutaneous transcatheter of an atrial septal occluder (ASO) device or open surgery. Closure using an occluder carries the risk of device embolization (DE). Case Presentation: This case series presents two patients who had dislodgement after ASD closure using ASO. The demographic data, comorbidities, surgical details, and follow-up results are all summarized. A 9-year-old girl and a 12-year-old boy admitted to our centre. The girl echocardiography evaluation revealed dislodgment of ASD occluder in a large secundum ASD, right upper PV blockage, and a high chance of pulmonary hypertension (PH). While the boy showed the occluder device that was misplaced and positioned in the right ventricle. A secundum ASD with a left to right shunt and moderate TR with a peak pressure gradient of 21.5mmHg were also found. During the procedure, we discovered that the girl had an occluder in the superior rim of ASD II 3x2 cm, which was dislodged towards the lower right PV, above the mitral valve, and the posterior occluder leaflet was removed by replacing a section of the rim. We discovered a secundum ASD with a dimension of 2x1cm on the boy The occluder was found behind the anterior cusp of the tricuspid valve. The retrieved occluder device appeared intact, and the tricuspid valve was injured, but no rupture. Conclusion: The occurrence of ASO migration is uncommon, necessitating further surgery for device removal, closure of the remaining defect, and ensure there is no cardiac erosion or rupture. Surgery can also alleviate symptoms including shortness of breath and palpitations. © 2024, Sanglah General Hospital. All rights reserved.

Item Type: Article
Additional Information: Cited by: 0; All Open Access, Gold Open Access
Uncontrolled Keywords: atrial septal defect; atrial septal occluder; device dislodgment; device embolization
Subjects: R Medicine > RD Surgical Divisions
Divisions: Faculty of Medicine, Public Health and Nursing > Surgical Divisions
Depositing User: Ngesti Gandini
Date Deposited: 17 Mar 2025 04:48
Last Modified: 17 Mar 2025 04:48
URI: https://ir.lib.ugm.ac.id/id/eprint/15777

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